What makes kids more susceptible to community-acquired severe pneumonia?

Community-acquired severe pneumonia is more likely to develop in young boys and children with severe stunting, reports a recent study. Fever, illness duration, and a history of prior medical care are also important predictive factors for severe pneumonia.

Researchers conducted a case-control analysis of 2,597 children aged 2–59 months (60 percent boys). Most (n=1,693) had severe pneumonia and were classified as cases, while the remaining 904 only had pneumonia and were deemed as controls.

Compared with controls, patients had higher fever (41 percent vs 20 percent) and pulse rate (17 percent vs 16 percent). Eleven percent of children with pneumonia developed hypoxaemia, which was completely absent in controls. Care-seeking behaviours were also nearly twice as common in patients than in controls (73 percent vs 43 percent).

Multivariable logistic regression analysis confirmed that high fever was a significant risk factor for severe pneumonia (temperature ≥38 °C: adjusted odds ratio [OR], 2.66, 95 percent confidence interval [CI], 2.17–3.26; p<0.001), as was prior receipt of medical care (p<0.001). Wealth was likewise an important predictor of severe pneumonia (p<0.001).

Moreover, boys (adjusted OR, 1.33, 95 percent CI, 1.11–1.60; p=0.002) were at a significantly greater odds of severe pneumonia than girls, as were those with severe stunting (adjusted OR, 1.44, 95 percent CI, 1.09–1.91; p=0.009). Disease duration ≥3 days also aggravated the likelihood of severe pneumonia (adjusted OR, 1.55, 95 percent CI, 1.19–2.02; p=0.001).